| Organization Name: | PLACITAS HEALING CENTER LLC |
| NPI Number: | 1780980417 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARA MOSCINSKA (OWNER) |
| Mailing Address: | 3 Homesteads Rd Ste E Placitas |
| State: | NM US |
| Postal Code: | 870439229 |
| Phone Number: | 5053851932 |
| Fax Number: | 5057713438 |
| NPI Enumeration Date: | 01/27/2011 |
| NPI Last Update Date: | 03/02/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0105421 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |